Life in Prison

A young woman is sitting in front of me in the health adviser’s office in a UK prison. The office would look like any consultation room at your GP’s, if it wasn’t for the bars on the windows, and the recurrent sound of keys, and doors being locked in the background. I will call this woman ‘Y’. I have to be very careful about what I disclose about her, even in the pages of this magazine. If accidently other inmates or prison officers knew her identity and HIV status, she could risk bullying, insults, ignorant remarks, refusal of sharing everyday objects such as cutlery and cups, and isolation. Inside prison, HIV is a secret that needs to be kept at any cost.

‘Y’ is in for a violent crime she has committed to help her boyfriend when she was still a teenager. She is only 21 years old and pregnant. ‘Y’ tells me her story, without searching for pity, just recounting the events that have happened in her life. Born in an African country at war, she became a refugee when still a small child. ‘Y’ and her family – her mother and other siblings – escaped the war, first to refugee camps in neighbouring countries, later on to northern Europe – the safest option. She has moved through several countries before settling in the UK.

If the horrors of war and exile weren’t enough, ‘Y’ was raped when she was eight, by a family member. That’s how she contracted HIV. It is not a surprise that her mental health is a big issue. The prison is very concerned about her. There will be meetings among psychologists, social workers, doctors and prison staff to decide if ‘Y’ is mentally and emotionally fit enough to have a baby.

While I talk to her, I get the impression that in spite of all she has been through there is force, clarity, and strength in this young woman. But her life and the life of her baby are – for now – in the hands of the ‘experts’, the ones with power.

When I leave prison and I go back to my home, it is difficult to leave ‘Y’ behind. I keep thinking about her. I feel sad, angry, and powerless. I can’t help asking myself: ‘Is prison really the best place for Y? Will she get any better in such an environment? Will she really have the possibility of move away from her past life and grow into her full potential? What will happen to her baby?’

‘Y’s story is dramatic, but it is not that unusual. So many of the women I see in prison have tragic pasts; addiction, abuse – including sexual abuse – neglect, and poverty are recurrent themes. I believe many of them suffer from mental health problems. This is just my observation as an outreach worker who has visited HIV positive women in a UK prison for the past eight years.

What do the experts say?

Well not much. One of the biggest problems about the situation of women in prison is that it is severely under-researched. For ‘security reasons’, everything about prison is very guarded. Prison is very hard for any body, but the added burden and terrible anxiety of having to guard the secret of HIV makes it a lot harder.

What is known about women in prison in the UK, at present, is that they are a fast-growing population. According to the Prison Reform Trust Report of 2006 in England and Wales, the number of women has increased by more of 200% in the past 10 years compared to a 50% increase in the number of men in prison during the same period. At present, there are more then 4,200 women in prison in the UK.

This increase in the UK follows global trends towards a greater use and popularity of imprisonment and a lack of interest in constructive alternatives such as non-custodial sentences. Those would be particularly relevant to drug offenses and non-violent theft. Drug offenders in particular, would be better dealt with by therapeutically addressing their addiction.

Prison has a tremendously harsh effect on women, for several reasons. Firstly, women offenders are often the sole carer of their children, (more often then male prisoners). Their imprisonment and separation from the children can cause major psychological traumas, which are very difficult for both the mother and the children. This has grave repercussion for all of us in the communities were those children live. If they are the head of their household, their incarceration could result in the loss of their home, and serious disruptions to the lives of the children.

Since there are fewer women’s prison, women are more likely to spend time in a prison which is far away from where they live, so that visits from family and friends are extremely difficult. Women in prison can experience profound isolation, which has an effect on their often already compromised mental health. Additionally, because there are few women’s prison, women convicted from a wide range of offences are often imprisoned together. This means that the overall regime will be determined by the maximum-security requirements of a very few high-risk prisoners. Overall, the prison system was designed to deal with male prisoners, because of this it actually often discriminates against women.

The Prison Reform Trust provides more chilling statistics on the circumstances of women in Prison.

More than half of women in UK prisons say that they have suffered domestic violence and one in three has experienced sexual abuse.

The educational achievement of women prisoners is lower than for male prisoners. 74% left school at 16 or before. Only 39% have any qualifications at all, compared to 82% of the general population. 41% of women prisoners have not worked in the past five years.

70% of women prisoners have two or more diagnosed mental health issues.

66% of women prisoners are mothers, and each year it is estimated that more than 17,700 children are separated form their mothers by imprisonment

Of all women who are sent to prison, 37% say that they have attempted suicide at some time during their life.

Rates of self-harm or injury in women’s prisons rose 48% in recorded incidents between 2003 and 2007. In 2006, women accounted of 11, 503 or 49% of total recorded incidents of self-harm, even though they form only around 6% of the prison population.

66% of sentenced women in prison say they were either drug dependent or drinking to hazardous levels before custody. A University of Oxford report on the health of 500 women prisoners found that 58% of women had used drugs daily in the six months before prison and 75% of women prisoners had used illegal drugs during that six month period.

One in four women in prison has spent time in local authority care as child.

The majority of sentenced female prisoner are held for non-violent offences. At the end of March 2008, the largest group (28%) was held for drug offences.

More women were sent to prison in 2006 for theft and handling stolen goods than any other crime. They account for almost a third (31%) of all women sentenced to immediate custody.

If you add to this bleak picture the hurdle of living with HIV, and often of being diagnosed, while in prison, it is clear that there is an extreme urgency for a radical prison reform that takes into account gender equity and the right to health of women prisoners.

Meanwhile women like ‘Y’ have to carry on the best they can with the support available. Fortunately ‘Y’ was allowed to have her baby in prison. In spite of the misery of being a first time mother behind bars, she has bonded with the baby and she seems as happy as she can be. Maybe also thanks to the fact that she wasn’t totally isolated, but she had the chance to talk about her feelings around HIV during Positively Women’s visits. Soon Y and her baby will come out of prison, there is still so much uncertainty about her future, and she is particularly worried that it will be hard for her to get a job because of her criminal record and her HIV status. However Positively Women will continue to support her and hopefully this will be a happy ending story. This is quite rare when you come out of prison.